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CHAM Examination Content Outline

The NAHAM Certification Commission is pleased to announce the release of the revised Certified Healthcare Access Manager (CHAM) exam content outline! The revised exam content outline will serve as the foundation for the CHAM examination, not only by providing framework for the elements of practice that will be tested, but also by establishing relevance and validity for the CHAM exam.  The October 2016 CHAM testing window was the first to utilize this content outline. The CHAM Study Guide has also been revised to accurately reflect the CHAM content outline.  

The CHAM examination addresses the following subject matter. Candidates are required to demonstrate proficiency by answering questions that evaluate their knowledge of facts, concepts, and processes required to complete the tasks described below.

I.  Pre-Arrival (25%)                                                                                 

                A. Patient and Family Experience

1. Deliver quality service and customer satisfaction

2. Analyze patient satisfaction surveys (e.g., Press Ganey, Gallup, etc)

3. Employ service recovery measures


                B. Admission and Transfer Services

1. Manage intra- and inter-facility referrals/transfers

2. Comply with contractual, legal, and regulatory requirements


                C. Scheduling

1. Assess customer expectations and special needs of the patient (e.g., age specific, interpretive service, and physical, cultural and emotional needs)

2. Arrange and schedule location, equipment, and/or staff (resources) and document pertinent schedule information

3. Identify information required to confirm service for a specific date and time

4. Inform patients of clinical prerequisites: Comply with requirements based on physician orders, protocols, and/or medical necessity


                D. Pre-Registration

1. Maintain integrity of enterprise master patient index (EMPI):

a. Create patient account

b. Validate/initiate medical record to ensure identification and safety


2. Perform financial clearance:

a. Identify accurate payer

b. Validate and meet payer requirements

c. Inform and/or collect customer financial obligations prior to service

d. Adhere to regulatory compliance standards (e.g., federal, state, and local)

e. Perform financial clearance (e.g., financial counseling, ensure payer authorization is obtained)

f.  Verify benefits


II. Arrival (35%)

                A. Patient Check-in, Admission, Registration

1. Administer patient registration processes:

a. Validate or obtain demographic, admission source, clinical, and financial information (e.g., patient identification validation)

b. Provide and explain patient registration forms (e.g., The Patient Bill of Rights and Responsibilities, HIPAA)

c.  Execute consents, signatures, and other required documents

d.  Comprehend medical terminology and coding


2. Validate ordered levels of care (e.g., inpatient, observation, and outpatient, status changes)

3.  Verify payer plan coverage (e.g., governmental payers, workers compensation, and insurance)

4.  Determine coordination of benefits

5.  Perform point of service collection

6.  Provide financial counseling


                B. Patient and Family Experience

1. Utilize services to help reduce patient and family stress and increase customer satisfaction

2. Facilitate internal and external way finding (e.g., transportation, parking, and drop-off and signage)

3. Identify relevant information to provide to patient and family (room number, visiting hours, etc.)

4. Manage patient directory exclusions

5. Employ service recovery measures (e.g., validating parking and free meal tickets)


                C. Revenue Cycle

1. Capture data elements necessary for accurate billing

2. Strategically align with case management, utilization review, clinical documentation, health information management (HIM)/medical records, billing, follow-up, cash posting, and accounts receivable

3. Mitigate denials management

4. Collaborate with managed care department (e.g., communicate payer issues)


            D. Information Systems

1. Manage timely input of data

2. Understand impact of patient management system transactions (e.g., electronic data interface, electronic medical records and ancillary systems)

3. Educate on system down time and recovery


III. Access Management (40%)

            A. Statistical Reporting

1. Determine benchmark processes to improve outcomes

2. Facilitate process improvement

3. Monitor trending areas of interest (e.g., payment, patient flow, and denials)

4. Develop, review, and refine key performance indicators (KPIs), best practices and dashboards

5. Track productivity


                B. Patient Experience and Management

1. Protect patient confidentiality

2. Measure customer satisfaction

3. Anticipate and manage customer expectations


                C. Professional Development and Competency

1. Develop and measure performance standards

2. Oversee quality metrics


                D. Leadership and Management

1. Collaborate with human resource management

2. Establish effective communication

3. Drive strategic planning

4. Adhere to regulations for compliance

5. Participate in disaster preparedness

6. Manage financial performance (e.g., forecasting, budget)

7. Maximize employee engagement

8. Embrace change management



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